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No description available.

Vision impairment is one of the most common disabilities among older adults and leads to excess disability. Roughly 12 million older Americans (60 years and older) report vision loss resulting in deficits in physical and cognitive functioning. Furthermore, visual impairment and blindness cases are expected to double by 2050. The CDC estimates that vision impairment is among the costliest conditions in the U.S. at $145 billion annually. Approximately 195,000 Tennesseans are blind or visually impaired (B/VI) and report having severe difficulty seeing even with glasses. B/VI Tennesseans are more likely to be in poor health, have mobility issues, and report having a fall in the previous year. The current study aimed to assess the prevalence of vision impairment and identify barriers to routine eye exams among older adults in Northeast Tennessee. A cross-sectional survey was carried out in March 2023 on a convenience sample of older adults (50 years and older) in Hawkins, Greene, Sullivan, and Washington Counties. We developed a survey in collaboration with representatives from the Aging and Vision Loss National Coalition (AVLNC) that was administered in community and senior centers. The study questionnaire included a series of questions on vision health, eye screenings, and barriers to eye care services. Data were also gathered on demographic characteristics, insurance status, and self-reported chronic conditions. Preliminary data from 123 participants have been analyzed. The majority of participants were 65 and older (71.5%), non-Hispanic White (91.8%), and female (70.7%) with income of <$24,000 (70.0%). One-third (33.1%) report their health as fair or poor and nearly half (48.2%) of participants have 4 or more chronic conditions. Underlying conditions are linked to eye problems. Half of participants have hypertension (53.5%) or hypercholesterolemia (47.4%) and nearly one-third (30.7%) have diabetes. The overall prevalence of difficulty seeing even with glasses was 26.3%. Two-thirds (67.9%) report at least one eye condition (cataracts, glaucoma, macular degeneration, and glaucoma). Twenty percent of participants do not see an eye care provider. Overall, two-thirds (66.7%) indicated at least one obstacle to eye care: cost (35.7%), limited/no insurance coverage (23.8%), transportation (16.7%), and distance (11.9%). Forty percent of participants report traveling 10 miles or less to see an eye care provider. reliminary analyses suggests that B/VI in older adults represents an overlooked and yet rapidly growing public health crisis that impacts healthy aging. Given the high prevalence of chronic comorbidities and eye-related diseases among participants, greater attention is needed on the importance of a healthy lifestyle, routine eye exams, and expanded access to affordable care to address known barriers to care. Multivariate analysis will be used to determine independent predictors of poor vision health in the study population.

Age-related macular degeneration (AMD)* and presumed ocular histoplasmosis (POHS) are common causes of macular degeneration. Both are major causes of blindness, with AMD being the leading cause of blindness in people over the age of 65. The major cause of visual loss in both categories is the presence of a subretinal neovascular membrane (NVM) in the macular. Sometimes these conditions can be treated successfully with laser therapy. Our task was to develop a regression model for predicting post-treatment vision as a function of time from treatment and baseline prognostic factors measured at diagnosis. The particular analysis of the model was to examine how patients' post-treatment vision is affected by baseline factors. A nested-error structure was used in a linear model. / Thesis / Master of Science (MS)

Decline in both visual acuity and visual performance is a fact of life for older people and their increasing share of the population requires that buildings be designed with their visual needs in mind. As their field of vision decreases, people find it harder to identify an objects location, distance, and orientation. Elderly people with vision impairments usually find it harder to perform daily activities such as navigation through indoor spaces. Functional vision can be improved by modifying the design of spaces, for example, with better lighting. However, architects typically do not know how to take the needs of the visually impaired into account in their design process, or simply do not think of doing so. The researcher designed and feasibility-tested a prototype person-centered tool to help architects judge how appropriate a designed space will be for visually impaired people. The study was conducted as a qualitative mixed-methodology research analysis. The researcher used knowledge from literature interpretation to rationalize the development of a person-centered prototype. The researcher immersed design PhD students and vision science experts to inform the prototyping process. Along with an expert group of design and vision science professionals, the researcher beta-tested the prototype during a mock design-process scenario. The researcher also selected a small group of industry experts to participate in open-ended interviews on post-use demonstrations to qualitatively triangulate the findings on the prototypes usability. The study summarizes the feasibility including the challenges of using the prototype for professional purposes and suggests improvement. / Ph. D.

No description available.

This thesis describes the impact of contact lens-related microbial keratitis in terms of incidence and severity. Disease outcome is defined by visual outcome, costs to the healthcare system, costs to the individual and duration of disease. A successful 12-month surveillance study was conducted of the populations of Australia and New Zealand to detect all cases of contact lens-related microbial keratitis. A random telephone survey of 32,000 households in Australia and 7,500 in New Zealand accurately determined the level of use of various contact lenses in the community. The impact of new contact lens types: silicone hydrogels and daily disposables were investigated. Increased risk persisted in overnight wear with silicone hydrogel materials. Microbial keratitis associated with silicone hydrogel materials had slightly shorter disease duration however other factors had a stronger influence on severity. Rigid gas permeable and frequent replacement soft lenses when used for daily wear constitute the lowest risk. Cost analysis was developed in a hospital case series of microbial keratitis. This analysis was applied in the surveillance study including cases managed in the private health care sector. Disease duration and associated costs are novel indices of severity for contact lens-related disease. The most dramatic effects on disease severity were seen with the type of organism involved. Keratitis attributed to environmental organisms (Gram-negative bacteria, Acanthamoeba, fungi and Nocardia species) were 10x more likely to cause loss of visual acuity, had longer duration of symptoms and incurred higher costs. Importantly, delays in receiving treatment increased disease duration and associated costs. Greater awareness of the need for specialist healthcare is indicated amongst health care providers and contact lens wearers. The hypothesis that overnight wear in silicone hydrogel lenses would not increase the risk of infection has been disproven. This information is of value to practitioners who are responsible for informing contact lens wearers about the risk of contact lens-related infections and should be weighed against the benefits of continuous wear. The identification of factors which contribute to the outcomes of disease will be used in education campaigns amongst health care providers and contact lens wearers to minimise the impact of disease.

Patienter med ögonsjukdomar är en stor patientgrupp som förväntas öka, då många av sjukdomarna är åldersrelaterade och befolkningen i världen blir allt äldre. Ett stort antal av patienterna kommer att förekomma på olika vårdavdelningar där de vårdas av annan orsak. Omvårdnad är sjuksköterskans huvudansvar och hennes profession medför att riktlinjer och lagar ska följas i samband med yrkesutövning. Syftet med pilotstudien var att undersöka sjuksköterskors erfarenheter av att ge omvårdnad till inneliggande patienter med olika ögonsjukdomar i anamnesen. Pilotstudien genomfördes med en kvalitativ metod och datainsamlingen skedde genom intervjuer. Data analyserades med kvalitativ innehållsanalys. Resultatet sammanställdes i tre kategorier: Att erfara bristfälligt ansvarstagande, Att erfara behov av prioriteringar och Att erfara okunskap om ögonsjukvård. Sjuksköterskorna erfor bristfälligt ansvarstagande och de ansåg omvårdnadsarbetet med patienter med olika ögonsjukdomar i anamnesen som svårt. De ansåg sig sakna tillräckligt med kunskap och arbetsbelastningen ledde till att de var tvungna att prioritera på ett sätt som inte gynnade patientgruppen. Sjuksköterskorna uttryckte ett behov av mer utbildning inom detta område. Mer kunskap skulle kunna bidra till att de upplevde en ökad trygghet i sin yrkesroll och leda till en högre patientsäkerhet. Pilotstudien visar att det finns förbättringspotential för att höja patientsäkerheten och som bör följas upp i en fullskalig studie. / Patients with ocular diseases are a large group which is expected to increase since many of the ocular diseases are age-related and world population is aging. These patients are found in various wards where they are inpatients because of other causes than ocular diseases. Nursing care is the nurse´s major responsibility and they are obliged to follow guidelines and laws regularizing their profession. The purpose of this pilot study was to investigate nurses´ experience of providing care for inpatients with any ocular disease, in their anamnesis. The pilot study was conducted using a qualitative content analysis using interviews. The results were compiled into three categories; Experiencing inadequate accountability, Experiencing the need for priorities, and Experiencing the ignorance of ophthalmology. The nurses in the pilot study experienced nursing care to patients with various eye diseases in history difficult. They thought they lacked sufficient knowledge and because of the workload which made them prioritize in a way which did not benefit the patients. The nurses expressed a need of more education in ophthalmic care. More knowledge would support them in experiencing an increased security in their profession and lead to improved patient safety. The pilot study shows that there is potential for improvement to enhance patient safety and should be followed up in a full scale study.

Att som äldre drabbas av grav synnedsättning påverkar livet på olika sätt och för ögonsjuksköterskan blir det viktigt att förstå dessa patienters upplevelser. Syftet var att undersöka äldres upplevelser av att drabba av åldersrelaterade ögonsjukdomar som ger en kraftigt nedsatt syn. Studien är en integrativ litteraturstudie där analysen resul­te­rade i tre områden av särskild betydelse för dessa patienter; att förlora sitt obero­ende, livet blev inte som planerat samt att finna nya vägar. Resultatet visar att äldre med synnedsättning var mindre aktiva, mindre självständiga, och mindre nöjda med livet än de med god syn. Det visade sig att äldres syn hade stor betydelse för deras upplevelse av hälsa. Genom ett personcentrerat förhållningssätt kan ögonsjuksköters­kan bemöta dessa pa­tienter i deras livsförändring och genom samtal förbereda patien­ten inför hur livet kan komma att förändras med synnedsättning, samt skapa realist­iska förhoppningar inför framtiden. Ögonsjuksköterskan kan förmedla kontakt med stödfunktioner såsom Syn­verksamheten och därmed hjälpa patienterna att finna nya lösningar i vardagen. / Learning how to live with severe visual impairment in old age affects many areas in their everyday life and for an ophthalmic nurse it is important to understand these pa­tients’ experiences. The aim of the study was to find out elderly people’s experiences of suffering of age-related visual impairment. The study is an integrative literature study in which the analysis resulted in three areas of special meaning for these pa­tients: loosing independence, life was not as planned and finding new ways. The result shows that elderly with visual impairment where less active, less independent, and less ple­ased with life than those with good visual ability. Research showed that el­der´s visual ability had great meaning of how they experienced their health. Having a person centered approach the ophthalmic nurse can support these patients in their life­style changes and through a dia­logue prepare patients for the upcoming changes of life living with visual impairment. The ophthalmic nurse can also support the patients to get realistic expectations of the future. The ophthalmic nurse can me­diate contact with supportive functions such as Synverksamheten, and thereby help pati­ents to find solutions coping with their everyday life.

Many standardized measures of cognition include items that must be seen or heard. Nevertheless, it is not uncommon to overlook the possible effects of sensory impairment(s) on test scores. In the current study, we investigated whether sensory impairments could affect performance on a widely used screening tool, the Montreal Cognitive Assessment (MoCA). Three hundred and one older adults (mean age = 71 years) completed the MoCA and also hearing and vision tests. Half of the participants had normal hearing and vision, 38% impaired hearing, 5% impaired vision, and 7% had dual-sensory impairment. More participants with normal sensory acuity passed the MoCA compared to those with sensory loss, even after modifying scores to adjust for sensory factors. The results suggest that cognitive abilities may be underestimated if sensory problems are not considered and that people with sensory loss are at greater risk of cognitive decline.